改良经腹食管裂孔入路行Siewert Ⅱ型食管胃结合部腺癌根治术的经验总结
Summary of Experience in Modified Trans-hiatal Esophagogastrectomy in the Treatment of Siewert Type Ⅱ Adenocarcinoma of the Esophagogastric Junction
杨根荣 1胡宝利 2韦海涛2
作者信息
- 1. 河南中医药大学第一附属医院胸外科,河南郑州 450000
- 2. 河南大学附属淮河医院胸外科,河南开封 475000
- 折叠
摘要
目的 探讨改良经腹食管裂孔入路实施Siewert Ⅱ型食管胃结合部腺癌根治术的创新性和优势,总结此改良术式的经验.方法 回顾性分析2022年2月至2023年3月接受改良经腹食管裂孔入路的手术方式治疗Siewert Ⅱ型食管胃结合部腺癌12例病例资料.结果 12例手术均顺利完成,术中应用切割闭合器打开部分左侧膈肌,联合左侧胸腔辅助操作孔完成下纵膈淋巴结清扫及消化道重建,手术时间(209.0±38.3)min,下纵膈淋巴结清扫数(7.1±2.7)枚,食管切除长度(7.7±0.8)cm,术中出血(168.2±83.1)mL,术后住院时间(11.6±1.8)d.结论 改良经腹食管裂孔入路的手术方式治疗Siewert Ⅱ型食管胃结合部腺癌安全可行,此术式下纵隔淋巴结清扫及消化道重建的难度显著降低,保证足够的食管切缘长度,适合在临床广泛开展.
Abstract
Objective To explore the innovation and advantages of modified transhiatal approach(TH)esophagogastrectomy in the treatment of Siewert type Ⅱ AEG,summarize the experience of this improved operation.Methods Retrospective analysis of 12 cases of Siewert type Ⅱ esophageal gastric junction adenocarcinoma treated with modified transabdominal esophageal hiatal approach from February 2022 to March 2023.Results The operation of 12 cases were successfully completed,incision part of left diaphragm with endo-gia during operation,complete lower mediastinal lymph node dissection and digestive tract reconstruction by combining with the left thoracic operation hole,operation time(209±38)minutes,lower mediastinal lymph node dissection(7.1±2.7),esophageal resection length(7.7±0.8)cm,intraoperative bleeding(168±83)mL,postoperative hospital stay(11.6±1.8)days.Conclusion The modified TH approach is safe and feasible for the treatment of Siewert Ⅱ AEG,the difficulty of lower mediastinal lymph node dissection and digestive tract reconstruction is significantly reduced,ensure sufficient length of esophageal incision edge,this surgical method is suitable for extensive development.
关键词
改良经腹食管裂孔入路/Siewert/Ⅱ型食管胃结合部腺癌/Orvil管形吻合/经验Key words
modified transhiatal approach/Siewert type Ⅱ AEG/Orvil anastomosis/experience引用本文复制引用
出版年
2024
NETL
NSTL
万方数据